American Healthcare Crisis: A Perfect Storm

Congratulations,
America, on passing your
historic healthcare legislation. I didn't think you had the courage (with your being so afraid of metric and all) :)

Below is a piece that
I wrote to illustrate how puzzled Canadians are about Americans who are afraid of public healthcare.

A perfect storm is in the forecast. 43 million Americans have no healthcare, a tsunami of baby
boomers will retire in the next 15 years, and health costs are soaring. Yet - Americans
sleep soundly at night. On occasion, there is a wakeup call but the groundhog sees no
shadow, hits the snooze button, and goes back to sleep. Is this sustainable? Will Americans
continue spending their hard-earned tax dollars on vote-getting missions to Mars or Iraq - versus that of life itself? Are Americans that cruel?

I say no. The America I lived in, (Massachusetts), rallied to the misfortune of a neighbour,
or a crisis, with as much passion as a Canadian would. So why, then, do Americans not rally
around the healthcare cause?

I discovered that when you break bread with Americans, and bring up the subject of national
healthcare, the debate loses all life support when those in opposition paint images of
wait-times and higher taxes. In some cases the feedback I received would make the late
Senator McCarthy proud. "Socialism", they say. "Big Government", they protest. I
quickly got the message. National Healthcare was a Do-Not-Discuss item at the lunch or dinner table.

Americans face a terrible dilemma. On one hand they're a great nation that has
faced and survived many a crisis. Yet, they have a disdain for anything that
smacks of Big Government and Government Control of their lives.

Healthcare Bill: Do Not Resuscitate

Is there a solution in politics? Is there some visionary politician that
could mobilize support for a healthcare system that wouldn't turn
suffering people away? Unfortunately, the last real attempt at
material change (Bill and Hillary's health bill) died on the
operating table. Furthermore, opposing politicians spray-painted
DO NOT RESUSCITATE graffiti all over capitol hill.

Will change ever occur? I believe it will, but the crisis will have to worsen.
If the number of uninsured Americans were to pass the 100 million mark,
then we're talking real vote power. Politicians will have no choice. As much as I
love Arthur C. Clarke, the proposed social-science-moon-base-project may have to wait.

A certain segment of Americans I spoke to, had a me-vote-Republican 'cause-me-want-low-taxes approach
to their political views. Lower taxes was all that mattered to them. Death and
suffering could change that. There's nothing like the death of a father, mother,
uncle, or brother, who just happens to be uninsured, to help change somebody's outlook.

American Healthcare is Great, if you can Afford it.

I was very happy with the healthcare we received when our youngest
child, Michael, was born (1996 - Concord, MA). I would rate the "service" as
slightly higher than we received in Canada for the birth of our oldest,
Sarah. One major difference between the two systems I found was the vast
amount of paperwork that occurred in the U.S. system. If my wife, Marianne,
so much as went to the doctor for a checkup, there were multiple mailings
to our house. I began to wonder if the cost of policing who gets what, in
regards to medical coverage, would be a higher systematic burden than
foregoing those charges. I didn't have to look far. There have been
multiple studies comparing the U.S. and Canadian healthcare system.
These studies may differ a few percentage points or pennies here and
there, but overall they confirm the obvious: The U.S. spends 24 cents
out of every health care dollar on paperwork while Canada is spending only 13c. No surprise.

The cost of the U.S. healthcare system today hovers around 12% of the gross
national product (GNP). By contrast, universal health systems in other countries
consume much less of GNP: Canada - 8.4%, Sweden 9.1%, West Germany - 8.2%, Japan 6.8%, UK -6.2%.

Canada's Secret Weapon: Volunteers

When my mother died last year, after a long bout with cancer, I got to
sample the Canadian healthcare system in full. I found no significant
waiting times for the 30 or so appointments and three stays in the hospital.
What surprised me was the number of volunteers involved in the Canadian
healthcare system. It seems that many of the healthy and able retirees were
investing a significant portion of their life by taking care of others. I was
dumbfounded when I found out that a hospital located in Barrie, ON, Canada (a
small city with a population of 80,000 or so), had over 1,000 volunteers that
helped run the place. It is this volunteer factor that will help sustain the
Canadian healthcare system through to the next millennium. American hospitals
have volunteers too, but I can't foresee any signing up to help HMO's debate
with a customer because they aren't eligible for certain treatment due to a
pre-existing condition.

>Imagine a Health Corps - a Mobilized Nation

The volunteer factor illuminates a potential movement that has been unexploited
by politicians. Kennedy had his Peace Corps. What about a Health Corps? What
about an organization that fights suffering and sickness in America? Imagine a
nation mobilized for such a patriotic cause. It isn't the fix for American
healthcare, but it could go a long way towards galvanizing a national movement
and therefore make some form of accessible healthcare possible to the uninsured
who make too much money to be covered by medicare, yet can't afford private
insurance. As uncourageous, unimaginative, and fearful as today's
focus-group-driven politicians may be, there is always a chance that
one great man or great woman will emerge. Canada has some growing to
do in this department as well. No Canadian politician has recognized
the Canadian healthcare volunteers for the heroes they are. Imagine if
they did. It would (big surprise) draw in more volunteers.

The New "New Deal" will Come by 2025

Events in the past few years have told us America's healthcare system won't be
changing anytime soon. Perhaps in 15 or 20 years, when the number of uninsured
and underinsured goes up to a 100 million, the door may open to change. Until
then Americans must be rich or be employed by a company with a good
healthcare plan. Many Canadians would call this an immoral situation
(in light of the billions the U.S. spends elsewhere). Yet, many
Canadians are ignorant of the political complexity of everything America.

Luckily, Canada Inhaled the 60's Idealism

Canada was lucky. The Canadian healthcare plan was instituted in 1970,
an idealistic and optimistic time in Canadian history. The future
looked golden. We'd just had our centennial in 1967 and Pierre Elliot
Trudeau, a confident multilingual intellectual prime minister was swept
to power in what was known as Trudeaumania. Unlike the United States,
there were no lurking dead Kennedy ghosts, no kids being sent home in
body-bags from Vietnam, and no Kent State. Our ghosts came shortly
thereafter (the FLQ crisis, inflation similar to the USA, and the energy
crisis). Also, for better or worse, the Canadian system of politics is
similar to the British parliamentary system. This means that when a party has
a clear majority they can pass any bill they want (with the only check and
balance being that they may not get elected in the next election). Thus,
since the Liberals (and Pierre Elliot Trudeau) wanted National Healthcare -
they got National Healthcare.

Dear Americans: Learn to Live with it

One nice American lady wrote me an email on the state of their
healthcare asking what they could do to help things change. My
answer, sadly, is not much. "Marry somebody who has a good
healthcare plan" seems to be one of the few crude answers
that come to mind. Even a former Prime Minister of Canada,
Jean Chrétien, knew better than to soapbox "the Canadian way"
as better than the American way in a recent speech in which he
addressed Canadian healthcare issues. Smart man. Why? It's too
complex an issue to discuss in a press conference. You can't
sound-byte an answer. Americans had their chance, in the 1960's,
to change things. Perhaps if JFK had lived it would be different.
Instead, we got Nixon. Old guard. Old ideas. And now that Americans
perceive themselves to be threatened, on a daily basis, the basic instinct
is to "go conservative". So, no change for American healthcare anytime soon.
Bush's "New Deal" money is better spent on make-work projects like Iraq and
space programs.